New Rochelle Nursing Home Administrator Inflated Claims For Treatments Never Provided To Collect Larger Medicaid Reimbursements

Talk of the Sound received newsletters from the Long-Term Care Community Coalition. Somehow this item escaped our attention at that time but for the record we want to post this story. It was reported in the Spring 2013 newsletter but first was made public by the New York State Attorney General Eric T. Schneiderman in 2011.

From LTCCC:

Glen Island Center for Nursing and Rehabilitation
Eufemia Fe Salomon Flores, RN
New Rochelle Between April 20, 2001 and March 8, 2012, Ms. Salomon Flores inflated the PRI scores submitted on behalf of nursing home residents. Since PRI scores are used to determine the level of care residents need, this led to the nursing home’s being reimbursed at a higher rate than what they were entitled to, and Ms. Salomon Flores executed a confession of judgment for $2.2 million. Ms. Salomon Flores also failed to report on her 2008 tax return $307,000 worth of income she had received from Glen Island through bogus companies for which she had a tax liability of $31,000. She had not paid those taxes.

MFCU Conviction 4/16/2012
MFCU Indictment 4/17/2011

From the NYS Attorney General:

A.G. Schneiderman Secures Prison Time For Nursing Home Employee Who Committed $2.2 Million Medicaid Fraud

Defendant Pleaded Guilty to Grand Larceny And Criminal Tax Fraud

Schneiderman: Those Who Defraud Taxpayers Will Be Caught And Held Accountable

WESTCHESTER – Attorney General Eric T. Schneiderman today announced that a former administrator at New Rochelle’s Glen Island Center for Nursing and Rehabilitation pleaded guilty to charges that she defrauded the Medicaid program out of $2.2 million and will face prison time. Eufemia Fe Salomon-Flores pleaded guilty to one count of Grand Larceny in the Second Degree, a class C felony, and one count of Criminal Tax Fraud in the Third Degree, a class D felony.

“Our cash-strapped state and Medicaid program cannot afford fraud, and my office will continue to hold accountable those who rip-off taxpayers,” said Attorney General Schneiderman. “Restoring New Yorkers' faith in their government and cracking down on those who try to cheat the taxpayers are among my top priorities. Today’s result should send a clear message that we will leave no stone unturned in the fight against Medicaid fraud, waste and corruption in New York State.”

The Attorney General’s investigation began after an informant revealed that the Glen Island Center had submitted information to the state Department of Health that falsified the type of care residents received. The investigation revealed that from February 12, 2003 to March 8, 2010, the Glen Island Center received an inflated Medicaid rate because Ms. Salomon-Flores exaggerated residents’ diagnosis, conditions and required treatments when she submitted the home’s quarterly reports to the State Department of Health. The defendant routinely stated that residents were receiving suction and oxygen treatments, as well as receiving treatments for cancer and infections, when such treatments were neither required nor given. Such information is used to determine reimbursement rates for its Medicaid-eligible residents.

The investigation also revealed that the defendant failed to report income and committed tax fraud. Ms. Salomon-Flores received payments from checks issued to Premier Health Care Staffing and Phil Am Health Care Professionals, bogus entities she owned. In 2008 alone, Ms. Salomon-Flores’s sham companies received in excess of $307,000 in income that she failed to report on her New York State tax returns. This resulted in a tax liability in excess of $31,000 due to the state of New York.

Ms. Salomon-Flores, a 63-year-old Manhattan resident, entered the guilty plea before the Honorable Richard Molea in Westchester County Court. She is scheduled to be sentenced on December 6, 2011.

This case is being prosecuted by Special Assistant Attorneys General Susan Bloom and Anne Jardine, Regional Director of the Attorney General’s Pearl River Medicaid Fraud Control Unit, under the supervision of Medicaid Fraud Control Unit (MFCU) Deputy Attorney General Monica J. Hickey-Martin. The investigation was conducted by Senior Special Investigators Dennis Johnston and Frank Bluszcz and Principal Special Auditor Investigator Ann Winslow, all of the Pearl River MFCU.

Attorney General Schneiderman thanked the New York State Department of Taxation and Finance for referring the tax investigation. Attorney General Schneiderman also thanked the New York State Office of the Medicaid Inspector General for referring this case.

New Yorkers are urged to report cases of suspected fraud to the Attorney General’s toll-free Medicaid Fraud Hotline, at 1-866-NYS-FIGHT (697-3444).